Diet Debate Obscures Truths About Salt Intake

At many large, national health meetings you will see an almost
comical presence of representatives from the salt industry. They are
there to promote the virtues of salt, and they have their little
pamphlets and booths set up next to the milk people, the American Heart
Association, and the myriad veterans of the scientific conference scene.

But the salt industry is nervous these days. The FDA announced in
April a plan to reduce the amount of sodium in restaurant and processed
foods gradually over the next decade.

The reason is that the FDA, along with most public health experts and
the Institute of Medicine — comprising the most lauded biomedical
researchers and doctors in the United States — are alarmed that most
Americans consume two to five times the amount of sodium they need each
day. They argue that reducing dietary sodium can save 150,000 lives per
year, largely by preempting high blood pressure, or hypertension.

A counter argument is shared, not surprisingly, by the salt industry,
most food manufacturers, and a sprinkling of admittedly earnest
biomedical researchers and epidemiologists.

This counter argument, which many of the mainstream media outlets
have bought into, is that reducing sodium at a population level to stave
off hypertension is a risky experiment lacking scientific merit. A
parallel and even more popular counter argument is that government
experts are food Nazis out to control our lives.

Sure, we need salt, which contains sodium, an essential mineral. But
we don't need more than 1,500 milligrams a day. Most of us consume 3,000
to 8,000 milligrams daily. It's a sad joke that the food industry is
fighting efforts to curb salt.

When it rains it pours

Most consumers have little idea how much sodium they consume and how
this is irrefutably linked to high
blood pressure, stroke and cardiovascular disease — and likely
linked to ulcers and heartburn.

The daily recommended allowance for sodium often is stated at 2,300
milligrams. But that level is for about a dozen or so Americans. The
real level for the rest of us — all children, all African Americans, all
adults over age 40, and anyone with high blood pressure — is 1,500
milligrams.

Food labels go by the higher level, of course, and you can easily be
deceived. Consider how Campbell's Condensed Chicken Noodle Soup has 890
milligrams per serving, which the company calculates to be 37 percent of
the daily allowance for sodium. This seems marginally acceptable, one
of three meals providing a third of the sodium limit. But the math is
fuzzy.

First, recalculate for the real level of 1,500 milligrams. That's 60
percent of your daily sodium — per serving, which is 8 ounces (half of
which is water). The 10.75-ounce can plus water makes about 2.5 servings
with about 2,300 milligrams of sodium, or 150 percent of your daily
limit.

If you add Saltines, well, forget it. That's another 40 milligrams of
sodium per cracker.

The salt is there because the food would otherwise taste bad.
Processed food is a science project made in a laboratory, not real food
made in a kitchen. The salt compensates for the blandness of cheap food
that's not ripe.

Also, various chemicals added to preserve shelf life, crispiness,
texture integrity when frozen and defrosted, or the many other problems
inherent in creating food in a factory that won't reach consumers for
weeks or months.

So what's a company to do? You can see how this board meeting will
unfold: Some gruff and embattled CEO will stand before the board, slam
his fist on the table, and demand answers for how they can reduce the
amount of salt in their processed foods and still have them taste good.
Some young visionary will stand up and say, "I know, why don't we use
only the freshest ingredients and get up early every day to cook and
deliver our food to local supermarkets."

The visionary promptly will be fired, and the discussion will turn to
finding a chemical that can replace salt.

What you can do, whenever possible, is cook
for yourself with whole foods so that you can control the level of
sodium. There are various tricks, too, like using sea salt or sea
products such as seaweeds that contain more of a salty taste with less
sodium.

A dash of truth

While less nefarious than the corn and sugar industries, with their
sunny ad campaigns promoting the natural goodness of these sweeteners,
the salt industry is nonetheless trying to redirect the argument.

When experts say there is no proof that reducing sodium levels would
reduce hypertension nationwide and subsequently reduce strokes and heart
attacks, they are correct. There's no proof, because such a suicidal
study to confirm this — placing a large group of healthy adults on a
high-salt diet and comparing them with a group on a low-salt diet —
would never be approved by an institutional review board, or IRB, a
committee that assures human studies aren't exceedingly dangerous.

Instead we have studies such as that published in February 2010 in
the New England Journal of Medicine, which found that reducing dietary
sodium by 1,200 milligrams per day would reduce the annual number of new
cases of heart disease by 60,000 to 120,000, stroke by 32,000 to
66,000, and heart
attacks by 54,000 to 99,000. This analysis is based on studies
showing the benefits of placing those with high blood pressure on a
low-salt diet.

Billions would be saved in health care costs, too. If food industry
magnates are worried about the rising cost of food manufacturing by
lowering sodium, surely they would be pleased that hundreds of thousands
of people will still be alive to buy their healthier products.

Christopher Wanjek is the author of the books "Bad
Medicine" and "Food
At Work." His column, Bad Medicine,
appears each Tuesday on LiveScience.

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Author Bio

Christopher Wanjek

Christopher Wanjek is the Bad Medicine columnist for Live Science and a health and science writer based near Washington, D.C. He is the author of two health books, "Food at Work" (2005) and "Bad Medicine" (2003), and a comical science novel, "Hey Einstein" (2012). For Live Science, Christopher covers public health, nutrition and biology, and he occasionally opines with a great deal of healthy skepticism. His "Food at Work" book and project, commissioned by the U.N.'s International Labor Organization, concerns workers health, safety and productivity. Christopher has presented this book in more than 20 countries and has inspired the passage of laws to support worker meal programs in numerous countries. Christopher holds a Master of Health degree from Harvard School of Public Health and a degree in journalism from Temple University. He has two Twitter handles, @wanjek (for science) and @lostlenowriter (for jokes).